Children born to teenage mothers have a significantly higher risk of death than women aged 20 to 24 years.

Birth-rate

There is denying that fact there has been a reduction of birth rates among teenagers since 1990s, but still nearly 11% of newborns are born to girls aged 15 to 19 years globally. The vast majority of these newborns babies (95 percent) are in low and middle-income nations.

According to the World Health Statistics 2014, the average birth rate among girls 15 to 19 years is 49 per 1000. The rate per country ranges from one to 299 births per 1,000 girls with the highest rates being recorded in Sub-Saharan Africa. Teenage pregnancy remains a major killer of the mother and child and prolongs the vicious cycle of poor health and poverty in most low and mid-income countries.

Context

While some teenagers want and plan their pregnancy, for many this is not the case. Pregnancies are more common among adolescents in poor, uneducated or rural areas. In some countries, extra-marital pregnancies are rare. Conversely, girls often experience social pressure to get married and once married, they are coerced to have children early. In low and middle-income more than 30 percent of girls marry before age 18, and nearly 14 percent before the age of 15.

Some teens do not know how to prevent pregnancy. Basic sex education is lacking in many countries. Sometimes they are ashamed or do not dare to resort to contraceptive services. In some cases, contraceptives are just too expensive or not widely available and in some cultures morally illegal. Even if the contraceptives are widely available, sexually active adolescents are less likely to use them than adults. Besides, girls are not always in the position to refuse unwanted sex or resist coercion and most of these cases go unreported.

Health consequences

Complications of pregnancy and childbirth are the second cause of death among girls aged 15 to 19 worldwide. However, significant decreases in death cases were observed in all regions since 2000, particularly in Southeast Asia, where the mortality rate increased from 219 per 1000 girls. Nearly 3 million unsafe abortions occur among girls 15 to 19 years annually, contributing to maternal mortality and causes lasting health problems.

Early pregnancy increases the risk for both mother and the child. In low and middle-income countries, stillbirths and neonatal deaths is 50 percent higher among children born to mothers aged fewer than 20 years than among parents aged 20 to 29. The younger the mother is, the higher the risk for both the mother and the child suffering from low birth weight and long-term health problems.

Social and economic consequences

During adolescence, pregnancies can have economic and social implications. Many young girls have to leave school when they become pregnant. As a result, in most cases these girls end up with little education and skills and this makes it harder for them to find a job. This is huge unwanted cost to the country, due to the reduction in the annual income that a young woman could have received her life if not for an early pregnancy.

WHO action

In 2011, in partnership the World Health Organization (WHO) published in the UN Population Fund (UNFPA), guidelines on how to prevent early pregnancies and their consequences for the female reproductive health. They recommended measures to be taken by countries with six primary objectives. They are:

reduce the number of marriages before the age of 18;

raise awareness to get support to decrease the number of pregnancies before the age of 20;

increase the use of contraception for adolescents exposed to unwanted pregnancies;

minimize the incidence of sex under duress teen;

reduce the number of unsafe abortions among adolescents;

Increasing the use of skilled care before, during and after childbirths among adolescents.

The WHO also participates in various joint efforts with organizations and programs such as the initiative “H4 +”, which includes UNAIDS, UNFPA, UNICEF, UN Women and the World Bank. This initiative aims to accelerate progress towards achieving the Goals 4 (Reduce child mortality) and 5 (improve maternal health) Millennium Development Goals by 2015.

It tackles the root causes of mortality and morbidity of maternal, newborn and child – which are gender inequality, child marriage and limited access of girls to education. The initiative “H4” is closely aligned with national health plans and provides technical and financial support to governments as well.